I cover cardiology news for CardioExchange, a social media website for cardiologists published by the New England Journal of Medicine. I was the editor of TheHeart.Org from its inception in 1999 until December 2008. Following the purchase of TheHeart.Org by WebMD in 2005, I became the editorial director of WebMD professional news, encompassing TheHeart.Org and Medscape Medical News. Prior to joining TheHeart.Org, I was a freelance medical journalist and wrote for a wide variety of medical and computer publications. In 1994-1995 I was a Knight Science Journalism Fellow at MIT. I have a PhD in English from SUNY Buffalo, and I drove a taxicab in New York City before embarking on a career in medical journalism. You can follow me on Twitter at: @cardiobrief.

After Hurricane Katrina, Timing Of Heart Attacks Shifted In New Orleans

Prior to Hurricane Katrina, heart attacks in New Orleans followed a well-known circadian and septadian (today’s word of the day, meaning day of the week) pattern, with predictable increases on Mondays and in the morning hours. Now a new study finds that the notorious 2005 hurricane dramatically altered that pattern for at least three years, shifting the pattern to a much greater than expected occurrence over nights and weekends.

Researchers analyzed data from myocardial infarction (MI) patients treated at Tulane UniversityHealth Sciences Center (TUHSC) and found startling differences in the timing of MI before and after Katrina. On a daily basis, they found a significant decrease in morning MIs but a twofold increase in evening MIs. On a weekly basis, they found a greater than twofold decrease in Monday MIs, balanced by an increase on weekends, especially Saturdays.

There were other differences in the patient population, undoubtedly reflecting the changes to New Orleans caused by Katrina. After Katrina, MI patients were more likely to be smokers, unemployed and uninsured. MI patients were also two years younger after the hurricane. As stress is an acknowledged trigger for MI, this may help explain some of the demographic changes.

The tremendous amount of stress after the hurricane may help explain the time shifts as well. The stress associated with waking up in the morning, and in particular waking up on Monday morning, is known to provoke the biological changes that underlie the established daily and weekly variations. The investigators speculated that after Katrina waking up and going to a job may actually have functioned as “a distraction from stresses associated with homelessness and other life alterations” caused by the hurricane.

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Thanks, Michael. I thought a lot about that part of the press release. Based on this paper and this data I don’t think it’s fair to conclude that there was a large increase in the number of MIs after Katrina. Since this was a single center study, and since Tulane was the first hospital to reopen after Katrina, and since the overall population changed so dramatically after Katrina, there’s really no way to know about the trends in the overall MI rate. I suspect, and this study offers some evidence, that after Katrina people were more likely to have an MI at a younger age, and people in NO certainly experienced a lot more stress, so it seems likely that the MI rate increased. But a threefold increase is extremely unlikely.